Summaries for Patients|18 December 2001

Musculoskeletal Pain and the Progression of Disability among Older Women with Disability

The summary below is from the full report titled “Widespread Musculoskeletal Pain and the Progression of Disability in Older Disabled Women.” It is in the 18 December 2001 issue of Annals of Internal Medicine (volume 135, pages 1038-1046). The authors are SG Leveille, S Ling, MC Hochberg, HE Resnick, KJ Bandeen-Roche, A Won, and JM Guralnik.

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What is the problem and what is known about it so far?

Many older people are disabled, which means that they have difficulty with or cannot carry out everyday activities, such as walking, bathing, dressing, eating, and using the toilet. Musculoskeletal pain (pain in muscles and joints) is also a common problem among older people. We do not know whether musculoskeletal pain is an important cause of disability in older persons.

Why did the researchers do this particular study?

To find out if musculoskeletal pain worsens disability in older women.

Who was studied?

1002 women who were at least 65 years of age and were living at home. All had some difficulty doing activities of daily living, walking one-quarter mile, or lifting 10 pounds. All of the women were participating in a large study called the Women's Health and Aging Study.

How was the study done?

The researchers interviewed the women in their homes at the beginning of the study and then again every 6 months for 3 years. During the first interview, the researchers asked questions about pain. In response, many women reported having moderate to severe pain in the arms, legs, and back, which the researchers called “widespread musculoskeletal pain.” During the interviews, the researchers asked each participant about her ability to perform activities of daily living (bathing, eating, dressing, transferring from the bed to a chair, and using the toilet). The researchers also asked the participants if they could walk one-quarter mile or lift 10 pounds. The researchers studied the relationship between widespread musculoskeletal pain and decreasing ability to carry out these activities over time.

What did the researchers find?

At the start of the study, one quarter of the women reported having widespread musculoskeletal pain. Compared with women who had no pain at the beginning of the study, women with widespread pain were two to three times more likely to report having severe difficulty in performing daily self-care activities, walking, or lifting. As time passed, women with widespread pain were nearly twice as likely as women with no pain to develop severe difficulty in carrying out these activities.

What were the limitations of the study?

All the women had some disability when the study began. This study does not give us information about women who had pain but no disability. It also does not tell us about whether treating the pain would prevent disability.

What are the implications of the study?

The degree of pain was moderate to severe. Serious pain in the arms, legs, and back is common among older women with disabilities and appears to increase the risk for worsening disability.

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